Prospective multicentre clinical trial of stapled transanal rectal resection for obstructive defaecation syndrome.
BACKGROUND
This prospective multicentre study assessed the safety and effectiveness of stapled transanal rectal resection (STARR) for treatment of obstructive defaecation syndrome (ODS).


METHODS
Between February 2001 and June 2006, 104 patients diagnosed with ODS were treated with STARR. Follow-up was scheduled for 1, 3 and 6 months after surgery, and annually thereafter. Variables related to the patient, surgical technique and outcome were analysed.


RESULTS
Mean operating time was 46.7 min. Haemorrhage at the staple line occurred in 55 patients (52.9 per cent). Three patients required surgical revision in the first 48 h owing to persistent bleeding. The median postoperative pain score was 2.4 on a scale from 1 to 10. Mean hospital stay was 2.2 days. The mean constipation score improved from 13.5 before surgery to 5.1 at 1-year follow-up (P = 0.006). Twenty-three patients reported faecal incontinence at 4 weeks after surgery, but only nine still had minor residual incontinence by 1 year. At a median follow-up of 26 (range 12-72) months, ODS had recurred or persisted radiologically and/or clinically in 11 patients.


CONCLUSIONS
STARR is associated with low morbidity and a short hospital stay, and is an effective alternative treatment for ODS.
Arroyo
A
A
Coloproctology Unit, Hospital General Universitario Elche, Elche, Spain. arroyocir@hotmail.com
González-Argenté
F X
FX
García-Domingo
M
M
Espin-Basany
E
E
De-la-Portilla
F
F
Pérez-Vicente
F
F
Calpena
R
R
D000328:Adult; D000368:Aged; D003248:Constipation / Q000601:surgery*; D005242:Fecal Incontinence / Q000601:surgery*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology; D006801:Humans; D007415:Intestinal Obstruction / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012002:Rectal Diseases / Q000209:etiology / Q000601:surgery*; D013577:Syndrome